• Specialist , Appeals

    Molina Healthcare (Tampa, FL)
    …+ Responsible for the comprehensive research and resolution of the appeals , dispute, grievances , and/or complaints from Molina members, providers ... internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to...of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid claims denials and appeals processing, and… more
    Molina Healthcare (05/22/25)
    - Related Jobs
  • National Contracting Director

    Molina Healthcare (Miami, FL)
    …for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances . * Coordinates with Corporate and Business ... regulatory requirements. * Monitors and reports network adequacy for Medicare and Medicaid services. * Develops strategies to improve EDI/MASS rates. * Educates and… more
    Molina Healthcare (03/04/25)
    - Related Jobs